Sub-specialties within Perioperative Nursing

May 11, 2016

Perioperative nursing is an advanced nursing specialty. A perioperative nurse will be trained to provide expert care for patients before, during and after any type of invasive procedure.

Before surgery, a perioperative nurse will prep the patient for the procedure. Inside the surgery room, they act as the patient advocate when the patient is under anaesthesia and incapable of making their own decisions. Post surgery, they keep a watchful eye on the patient as the effects of the anaesthesia wear off.

Within this nursing field, there are several other sub-specialty roles including holding bay, scrub or instrument, circulating, anaesthetic and recovery room nurse. Sometimes a perioperative nurse may fulfil multiple roles during a particular surgery depending on the nature and complexity of the procedure. On the other hand, some of these position titles may be used interchangeably in different hospitals and medical settings.

A perioperative nurse is an integral part of a surgery team, where they work in close collaboration with the other members of the team including the surgeon, surgical assistant, anesthesiologist, surgical technologist and other professionals. They use critical thinking skills, sound judgement and interpersonal communication skills to check and evaluate the patient’s needs, ensuring positive outcomes throughout the process.

Holding Bay Nurse

Holding bay nurses are responsible for the admission and care of patients who are brought into the pre-operative area or the holding bay. An important part of their job includes obtaining vital medical information necessary to prepare patients for surgery and relaying this information to the surgical team. Such information can include patient allergies, pathology and radiology reports, fasting status and sensitivities to medication.

Scrub Nurse/Instrument Nurse

Scrub nurses, also known as instrument nurses are primarily responsible for all supplies used within the surgical theatre. They anticipate the requirements of the surgical team and ensure that all necessary surgical supplies are sterile, functional and set-up in readiness for use. Scrub nurses remain vigilant throughout the surgical procedure, closely monitoring the patient’s changing condition and respond appropriately in case of any intra-surgical complications. During the procedure, they are responsible for handing equipment or tools to the surgeon upon request.

Anaesthetic Nurse

An anaesthetic nurse works under direct supervision of the anaesthetist. These specialists provide support to the patient and anaesthetist before and during the surgical procedure. Part of their task includes assisting the anaesthetist in administrating anaesthetic during surgery, preparing all sedation equipment and monitoring the patient’s condition throughout. They may also assume some duties of the circulating nurse if necessary.

Circulating Nurse

The main role of the circulating nurse is to be attentive to the needs of the surgical team during the procedure and ensure that all surgical supplies are promptly and correctly provided to the operating theatre. They are also responsible for the documentation and management of all supplies used in the surgical area. Other tasks of a circulating nurse include verifying patient consent forms, collecting patient specimens and preparing the required surgical equipment.

Post-Surgery Recovery Nurse

The post-surgery recovery nurse provides patient care immediately after the surgery. These specialist nurses are responsible for the patient’s safety while they are coming out of the anaesthesia. Some of their job functions include ensuring that the patient’s airway passage remains open, providing post-operative pain and nausea relief, responding to changes in the patient’s condition, recording results from regular observations of the patient, and administrating medication as prescribed by the physician.

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